Immunobiology Research Group, The Heart Research Institute, 7 Eliza Street, Newtown, NSW 2042, Australia.
Discipline of Medicine, The University of Sydney School of Medicine, Camperdown, NSW 2006, Australia.
Int J Mol Sci. 2018 Jun 5;19(6):1680. doi: 10.3390/ijms19061680.
Almost 600 million people are predicted to have diabetes mellitus (DM) by 2035. Diabetic patients suffer from increased rates of microvascular and macrovascular complications, associated with dyslipidaemia, impaired angiogenic responses to ischaemia, accelerated atherosclerosis, and inflammation. Despite recent treatment advances, many diabetic patients remain refractory to current approaches, highlighting the need for alternative agents. There is emerging evidence that high-density lipoproteins (HDL) are able to rescue diabetes-related vascular complications through diverse mechanisms. Such protective functions of HDL, however, can be rendered dysfunctional within the pathological milieu of DM, triggering the development of vascular complications. HDL-modifying therapies remain controversial as many have had limited benefits on cardiovascular risk, although more recent trials are showing promise. This review will discuss the latest data from epidemiological, clinical, and pre-clinical studies demonstrating various roles for HDL in diabetes and its vascular complications that have the potential to facilitate its successful translation.
预计到 2035 年，将有近 6 亿人患有糖尿病（DM）。糖尿病患者的微血管和大血管并发症发生率增加，与血脂异常、对缺血的血管生成反应受损、动脉粥样硬化加速和炎症有关。尽管最近的治疗取得了进展，但许多糖尿病患者对当前的治疗方法仍然没有反应，这凸显了对替代药物的需求。越来越多的证据表明，高密度脂蛋白（HDL）能够通过多种机制挽救与糖尿病相关的血管并发症。然而，在糖尿病的病理环境中，HDL 的这种保护功能可能会变得功能失调，从而引发血管并发症。尽管最近的试验显示出了希望，但 HDL 修饰疗法仍存在争议，因为许多疗法对心血管风险的益处有限。本文将讨论来自流行病学、临床和临床前研究的最新数据，这些数据表明 HDL 在糖尿病及其血管并发症中的各种作用，这些作用有可能促进其成功转化。
